Foot Care may Prevent Diabetes related Amputations among diabetes patients with Kidney Failure on dialysis: JAMA

A recent retrospective cohort study published in the Journal of American Medical Association highlight the critical importance of foot and ankle care for patients with kidney failure who are at risk of diabetes-related foot ulcers (DFUs). The patients who received foot and ankle care from podiatrists in the three months preceding a DFU diagnosis experienced significantly better outcomes when compared to those who did not. Among the nearly 15,000 adult patients analyzed, 18.4% received podiatric care prior to their DFU diagnosis.

The study analyzed data from 2016 to 2019 and found that patients who had received podiatric care were older, more likely to be male and had more comorbidities than those who hadn't. However, they expressed a lower likelihood of death and/or major amputation, as well as a reduced likelihood of major amputation alone. Over a mean follow-up period of 13.5 months, 70% of patients with podiatric care experienced death and/or major amputation when compared to 74% in the non-podiatric group. The survival probabilities at 36 months were notably higher among those who received foot and ankle care.

The multivariate regression analysis further reinforced the association between foot and ankle care and reduced the likelihood of adverse outcomes. The patients who received such care were associated with an 11% lower likelihood of death and/or amputation, and a 9% lower likelihood of major amputation.

These findings underline the importance of proactive foot care in reducing the risk of diabetes-related amputations among patients with kidney failure. With diabetes being a common comorbidity in individuals undergoing dialysis to ensure regular foot and ankle care by podiatrists could significantly improve the outcomes and quality of life of patient.

Source:

Tan, T.-W., Caldwell, B., Zhang, Y., Kshirsagar, O., Cotter, D. J., & Brewer, T. W. (2024). Foot and Ankle Care by Podiatrists and Amputations in Patients With Diabetes and Kidney Failure. In JAMA Network Open (Vol. 7, Issue 3, p. e240801). American Medical Association (AMA). https://doi.org/10.1001/jamanetworkopen.2024.0801